Ensuring Your Teen’s Sports Physical Is Thorough

When it comes to your teen’s health during the sports season, it’s important to make sure they get their annual physical exam. But, it’s just as important to make sure they are seen each year by a pediatric specialist when undergoing this exam.

“Having a sports physical completed by a family pediatrician allows parents to walk away a little more confident knowing their child can safely participate in a sport, in addition to understanding that all medical issues have been addressed by someone who is familiar with their teen,” says David Marshall, MD, Medical Director, Sports Medicine Program, Children’s Healthcare of Atlanta.

Why does my teen need a sports physical?

In Georgia, all high schools, most middle schools and many club teams require athletes get an annual pre-participation sports physical exam before the beginning of each sports season. The sports physical should be completed six weeks prior to the beginning of the season to allow adequate time for follow-up and correction of conditions that might be discovered and not delay the beginning of the season. Some common conditions may include abnormal blood pressure, a heart murmur, tight hamstrings, incomplete recovery from a previous injury or poor core strength.

Multi-station exams aren’t always best

It may be popular for student athletes to participate in locker room sports physicals or multi-station exams in which they undergo mass screenings by a team of volunteers like nurses, athletic trainers, sports physical therapists and sports-trained physicians. But there are often important teen health concerns addressed by your child’s pediatrician that may not come up if you bypass your regular doctor for a group participation exam.

What national experts say

While locker room physicals or multi-station exams may be more cost-effective or take less time, six national primary care and sports medicine organizations, including the American Academy of Pediatrics, recommend sports physicals be performed during a teen’s annual primary care exam.

Experts recommend incorporating the sports physical into the student athlete's routine health screening visit with their pediatrician for important reasons related to privacy, access to comprehensive medical records, time for discussing growth and development, and updating immunizations. This may be the only time your teen is in front of a healthcare professional, and it offers a vital opportunity to discuss adolescent health issues. This opportunity may be missed with the mass screening format, and the teen is more likely to be honest with his pediatrician when discussing sensitive issues like drug, tobacco and alcohol use, vaping, sexuality, sleep, mental health and depression.

4 reasons a pediatrician should perform your child’s sports physical

Scheduling an appointment for your child to see their pediatrician for a sports physical can help better:

  1. Determine the general health of the student athlete, including his mental health. Using the “HEADS” acronym, a pediatrician will learn more about an athlete’s:
    Home–A nurturing home environment is important when determining if a teen is ready to play a sport. A pediatrician may ask: Who do you live with? How much screen time do you get? Are you eating healthy meals? How many hours of sleep does your teen get each night?
    Education–This is an opportunity for a pediatrician to find out if a teen is doing well in school, whether grades are increasing or decreasing, and if he is on track to graduate on time. Slipping grades may also be an indication of depression.
    Alcohol–A pediatrician can learn if he is using alcohol or if he has access to it in his home.
    Drugs–It is important for a doctor to know what drugs a teen is taking. For example, prescription and nonprescription medicine for allergies, antihistamines and caffeine, as well as a condition like ADD, can increase the risk for heat-related illness. It also gives the pediatrician a chance to ask whether he is using opioids, illicit drugs or performance enhancement drugs.
    Social–It is important for a pediatrician to know what a teen does in their spare time; whether he has friends or if he spends a lot of their time in isolation maybe playing video games.
  2. Identify any life-threatening conditions. Oftentimes on a pre-participation sports physical, an athlete is asked if there are any pre-existing conditions he suffers from or if there is a family history of a condition, such as sudden cardiac arrest, sickle cell disease, heart murmur, asthma or blood pressure. If a parent is not present during a multi-station exam, the teen may not know the answer to these questions, further putting him at risk during the sports season.
  3. Identify conditions that may lead to another injury. A pediatrician should be aware of whether a teen has any previous injuries, such as multiple ankle sprains or a concussion, to ensure they were treated properly. This knowledge helps a coach or trainer be weary of the possibility of a growing athlete being at risk for another injury. And, if the injury isn’t rehabilitated correctly it could cause worse injuries in the future.
  4. Satisfy state requirements. In order to play sports at a middle or high school in Georgia, an athlete must complete a yearly physical in order to meet state requirements. It is valid for 12 months from the date the exam was performed, but with the following exception: If the sports physical was performed on or after April 1 it will be valid until the end of the following school year. The sports physical makes the following recommendations:
    • An athlete is cleared for participation without restrictions.
    • An athlete is cleared for participation, but the doctor conducting the exam recommends the teen follow up for a specific condition, such as tight hamstrings, skin rash or poor core strength.
    • An athlete is not cleared to play until further evaluation for a specified condition, such as a heart murmur.

Referring athletes to a specialist

If there are any sports-related issues a pediatrician is concerned about during the physical exam, he can refer an athlete to a sports medicine primary care physician, sports physical therapist or orthopedist for further evaluation. During a multi-station exam, doctors may not take time to refer a patient to a specialist if needed, so this is another important reason why a visit to the primary care doctor is so important.

Visit choa.org/sportsmed to find a pediatric sports medicine specialist. 


David L. Marshall, MD, a Pediatric Sports Medicine Primary Care Physician, is board-certified in pediatrics and sports medicine. His expertise lies in the diagnosis and management of nonsurgical musculoskeletal injuries in growing athletes. Dr. Marshall is Medical Director of the Sports Medicine Program at Children’s Healthcare of Atlanta and an adjunct clinical professor in the Department of Orthopedics at Emory University. He is on the medical advisory board for the Georgia High School Association and is a founding member of the Pediatric Research in Sports Medicine (PRiSM) organization. Currently, he is focused on performance enhancement through the use of video motion and physical therapy.